The healthcare reform bill has been on the table and the news for quite a while – so we wondered what the ralliers meant by “immediate reform”. Professor Jim Morone, Chair of Political Science at Brown University, says healthcare is a particularly tricky issue and has been a battle in the Congress since the time of Roosevelt.

“This is a battle for control over Washington DC. If the democrats win this battle, they will achieve something they’ve been trying to do for 75 years.”

It’s never come to a vote in either house before. It’s really a remarkable achievement to get this close. (minutes 1-2.30)”

So the Republicans will keep trying to block any attempt at healthcare reform. This is why the election of Scott Brown in Massachusetts as the 41st Republican in the current Senate was such a huge blow to the reform bill – it gave Republicans the ability to filibuster it. The US, unlike most countries, requires more than a simple majority to pass a bill in the Senate – the rule is that 40%+1 opponents can crush it, that is to filibuster it. Even without Scott, Republicans have filibustered 100 acts in the Senate the last one year alone – an absolute record.

What, then, did the protestors expect from the government? Turns out there’s a loophole. Says Daniel Bass,

“In order to pass strong legislation that will put Americans to work, that will cover more Americans, that will help control the costs, the Democrats are going to have to pass it through reconciliation.”

Reconciliation is a special provision that applies to bills that relate to the budget. The healthcare bill, obviously, meets this criteria. In such cases, you can pass the bill with only 51 votes in the Senate. Importantly, a version of the bill already passed in the Senate in December, so this is not the preliminary, or first, vote. That’s what makes it possible to use reconciliation. You can say – it’s passed already, and now we’re going to make it final with a simple majority because it relates to the budget, and we can discuss changes later.

Which bring us to why this bill is so hard to pass in the first place. Republicans believe that healthcare, the same as everything else, must be governed by markets. Democrats disagree, and say that healthcare is the one place markets can’t be allowed to work. Professor Morone explains:

“Healthcare is unique – you can’t allow failure, and markets require failure.”

Market failure means that now and then, you’ll be paying more for things than is best, and sometimes you’ll be paying less; sometimes there won’t be enough healthcare, and sometimes too little. This is why most other countries do have government control over the healthcare system – France and Canada for example, and they have the most efficient systems in the world. Does the American public have such a strong aversion to socialized medicine? Not really. The evidence, says Professor Morone, is Medicare.

“The Great irony is that it is the second most popular government program in America. So Americans in fact love socialized medicine and no politician would dare say ‘We wanna stop Medicare”.

So this bill will help 30 million more Americans get covered. It offers a tax subsidy to the people who need it so they can use it to buy private insurance. It won’t let insurers say – you have a pre-existing condition, so we can’t cover you. And yet, it’s going to have a hard time getting through. And this, as we saw, is because this is a battle not for better healthcare, but for more power at the Oval House.

For WBRU News, I’m Urmila Nair.

The BRU Brief airs weekly on 95.5 FM, recapping the week’s top local, national, and international stories, and taking a closer look at the issues of the day in Southern New England. Tune in on Monday nights at 11:00, or stream live at news.wbru.com.